Reply from Authors re: Behfar Ehdaie, Karim A. Touijer. 5-Alpha Reductase Inhibitors in Prostate Cancer: From Clinical Trials to Clinical Practice. Eur Urol 2013;63: 788-9 5-Alpha Reductase Inhibitors in Prostate Cancer

摘要

We agree with the introductory comments in the editorial by Ehdaie and Touijer [1]. Our understanding of the role of endocrine factors, such as androgen synthesis, in the tissue of castration-resistant prostate cancer (PCa) has improved rapidly and may result in more effective ways of interacting with the androgen receptor with the promise of rapid clinical application. We also agree that despite availability of data from several randomized controlled trials [2-4], progress with respect to the application of 5-alpha reductase inhibitors (5-ARIs) for PCa prevention has been less convincing. However, the finding of rising prostate-specific antigen (PSA) after potentially curative management of PCa is one of the conditions with which clinicians are most frequently confronted, and no first-line evidence-based treatment is available. We are therefore confronted with a difficult question: How much uncertainty around treatment decisions is acceptable in a situation of ignorance of the best management of proven minimal PCa progression?